Introduction/ Executive Summary

This Independent Advisory Group was appointed in mid-April 2019 with a remit to advise the Chief Medical Officer on how recommendations made in two earlier reports on breast cancer management in NHS Tayside should be implemented.

The aim was to rebuild relationships and maintain public confidence in the safe and effective delivery of cancer medicines within the North Cancer Alliance.

It is important to note what the remit did not include. It was not part of the Group's role to comment on the clinical decisions made by medical staff in NHS Tayside, nor to review individual cases. The Group was asked to aim to report in June 2019 and, in conducting this work, the Group acted independently of both the Scottish Government and NHS Scotland.

The membership of the Group included a range of expertise, including cancer specialists, senior pharmacy and service management. Where a need for additional expertise or advice beyond the core membership was identified, it was sought from a range of individuals across NHS Scotland. The Group would like to thank all of those who freely and willingly shared their knowledge and experience. Most of all, the Group would like to thank those patients and family members who met with or wrote to the Group to share their experiences - they were able to provide invaluable insight.

Scotland is a small country, with ambition to deliver high quality health care for all. Patients across Scotland should have access to the same high level of care and treatment, regardless of where they live. Crucially, they must also have the same level of involvement in decision making about their care. The Group is reassured that NHS Tayside is making significant improvements to cancer multi-professional working, but there are lessons to be learned from this occurrence that should be applied across NHS Scotland. It would have been a failing of the Group if it had only considered one health Board in isolation and if a similar scenario later occurred elsewhere.

Therefore the Group considers that the 19 recommendations made in this report, if adopted, will significantly improve cancer care across NHS Scotland by embedding a 'Once for Scotland' approach and facilitating the rapid sharing and adoption of best practice across regional cancer networks and their constituent NHS Boards.